CommuniCare Health Services - Heartland -
Pre Authorization Specialist
Due to continued growth, CommuniCare Health Servicesis currently recruiting for the position ofPre AuthorizationSpecialist for our Medical Practice. This is a remote position that can work from anywhere!
Under the general supervision of the Revenue Cycle Director, the Pre Authorization Specialist assists in the prior authorization process.
Beyond our competitive wages, we offer all full-time employees a variety of benefit options including:
- Medical, Dental, and Vision
- 401(k) Employer Match with Flexible Spending Accounts
- NOW OFFERING DAILY PAY! WORK TODAY, GET PAID TOMORROW.
CATCH THE SPIRIT!
When you join the CommuniCare family, youll quickly catch the team spirit. Coworkers and residents become family, the workplace becomes a home, and a touch of spontaneity and fun keeps everyone smiling. Our core values promote an environment of respect, courtesy, and professional excellence where you can dedicate yourself to a career you love.
QUALIFICATIONS AND EXPERIENCE REQUIREMENTS
- Excellent written and verbal Communication; verbally on the telephone
- Ability to multi-task on the computer
- Proficient in MS Office Suite Applications (MS Excel, MS Word, MS Power-point, etc.)
- Ability to type 35 wpm
- Ability to learn and use multiple proprietary software
- Need to be able to organize work duties and prioritize
- Problem Solving skills
- Dependable, reliable, responsible and honest
- Experience with health insurance a plus
- Clinic Healthcare Experience a plus
JOB DUTIES AND RESPONSIBILITIES
As Pre Authorization Specialist, you will:
- Review and approve physician inquiries for pre-authorization and medical necessity requests based on established pharmacy guidelines and contract criteria.
- Keep abreast of industry trends and regulatory changes in the healthcare industry and incorporate knowledge in the performance of job duties. Identify problems in process/procedures or services and make recommendations for improvements.
- Maintain a balance of productivity, quality, and timeliness of job accountabilities.
- Participate in department self-audit procedures for on-going evaluation of service.
- Maintain and update internal databases. Enter application information, prior authorizations, and other relevant data. Ensure database information and appended files are current and accessible to staff. Generate reports and other information requested on a scheduled/as needed basis.
- Create and support an environment which fosters teamwork, cooperation, respect and diversity. Establish and maintain positive communication and professional demeanor with employees and clients at all times.
- Perform other related duties as assigned.
- Attend required training.
Does this sound like your kind of job? This job is ideal for you if you are:
- Dependable -- more reliable than spontaneous
- People-oriented -- enjoys interacting with people and working on group projects
- Adaptable/flexible -- enjoys doing work that requires frequent shifts in direction
- Detail-oriented -- would rather focus on the details of work than the bigger picture
- Achievement-oriented -- enjoys taking on challenges, even if they might fail
- Autonomous/Independent -- enjoys working with little direction
- Innovative -- prefers working in unconventional ways or on tasks that require creativity
- High stress tolerance -- thrives in a high-pressure environment
THE COMMUNICARE COMMITMENT
A family-owned company, we have grown to become one of the nations largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, to reach out with our hearts and touch the hearts of others. Through this effort we create Caring Communities where staff, residents, clients, and family members care for and about one another.